NHS reforms: 'They didn't pause and they didn't listen' - The Guardian

NHS reforms proposed by the coalition have provoked thousands and comments and advice from Guardian readers on the blog. Photograph: Dominic Lipinski/PA

Readers of the Guardian's NHS live blog have shared feedback on the government's plans for NHS reform and its listening exercise over the last three months. Since April they have discussed the impact of the reforms on social care, cancer patients, mental health services, GPs, nurses, abortion, medical training and more, offering their take on what "pausing" the bill would mean for the government and the political parties.

Concern about the effect of GP commissioning, perhaps the most popular topic of discussion on the blog, has ranged from debates on whether consortiums would create a conflict of interest for GPs faced with managing costs and patient care, to how GPs' relationships with secondary and tertiary services would be affected.

Support for consortiums involving nurses, hospital staff and patients has been present, with some readers arguing that the principles of GP commissioning are sound, given doctors' greater knowledge of the patients in their care. Uncertainty over how such consortiums would work in practice and slot into the existing network raised greater anxiety, however.

Thousands of comments have been left by readers, giving the overwhelming impression that they feel they have not been listened to in this process. Regular badger33 explained how primary care trusts (PCTs) struggled properly to consult frontline staff, while benmandel expressed widely held concerns that the role of the patient and relatives has been marginalised in the proposals.

Many commenters, including Leibowitz and onepairofhands, shared frustration about how the official listening exercise had been run, arguing that the reforms were insufficiently debated during the election and would be implemented from the top down.

Despite the "pause", many of our readers have shared accounts of changes already taking place, as reader cmoser explained. The pace of the change was a concern for many, including Watty145 and cfarrar, who wrote: "I have been through 12 structural reforms in the 30 years that I have worked for the NHS and all they do is distract from the real work of the NHS to deliver and improve health and health services." Or as PleaseSeeSense put it: "They didn't pause and they didn't listen."

NHS worker ces1 spoke for many on proposals to increase private provision: "My biggest concern is that the private sector just won't provide what the NHS does – and that no one has costed for everything the NHS provides currently."

Combined with cuts in funding to many specialist services, readers expressed fears that healthcare for those who need it most could be threatened. There was strong opposition to creating a tiered system for accessing healthcare – a prospect seen by many as an inevitable outcome.

Hundreds of readers have used the blog to share experiences as NHS patients and workers. Many have suggested where efficiencies could be brought in and changes made. Taken as a whole, it has been a valuable "listening exercise" for any government.

Steve Field GP, 51, is the man charged with leading the government's listening exercise as chair of the NHS Future Forum. The head of the Royal College of GPs from 2007-10, he was the first senior doctor to support Andrew Lansley's NHS reform white paper in 2010.

While head of the most controversial review dominating the political world, the Department of Health says that he continues to practise as a GP at Bellevue medical centre in Birmingham, where he is married with two children.

In one of his listening exercises he revealed that his wife was suffering from cancer and requires expensive drugs for her treatment.

Born in the West Midlands, he lists his hobbies as tennis, family and walking his flat coat retriever dog, Hattie.

Field practised in Droitwich Spa in the 1980s and gained an international reputation in healthcare education as medical dean for the NHS in the West Midlands.

He received a CBE for his services to medicine in the Queen's 2010 New Year honours list.

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